Posted by Chit Sin on August 12, 1999 at 02:24:07:
In Reply to: Re: Undescended Testes posted by CLDing on August 07, 1999 at 10:03:59:
A most unusual presentation! I still like to think that hermospermia was a red herring here. Bilateral testicular cancers are almost always associated with cryptorchidism and seminomas outnumber non-seminomas by 2:1. Seminomas seldom bleed into themselves (unlike teratoma) let alone down the vas! However, the literature abounds in cases of association of intersex, particularly persistent Mullerian duct syndrome with bilatera cryporchid testicular cancer. The bleeding could be from a persistent Mullerian structure! Did CT reveal any midline pelvic mass?
I have found MRI very helpful in locating testis, both intra and extraabdominal. What would you have done if groin exploration was unfruitful in him?
Capsular invasion is seldom referred to in published literature. I would treat vascular or lymphatic invasion as stage II disease and either irrdiate or give them chemo up front. However, I send them all to my oncologists.